• The vast majority of women with invasive vulvar carcinoma are postmenopausal. But there has been a definite trend over the past two decades of an increasing incidence of carcinoma in situ and invasive squamous cell carcinoma in younger women. Forty percent of women with carcinoma in situ are under 40 years old. • Five to ten percent of women with invasive vulvar carcinoma have a history of genital warts, and 15 percent have a history of or subsequent diagnosis of a cancer confined to the skin (carcinoma in situ) or invasive carcinoma of the cervix . • Approximately 80 percent of the invasive squamous lesions of the vulva are associated with human papilloma virus types 16 or 18. • Other sexually transmitted diseases such as syphilis, lymphogranuloma venereum and herpes simplex virus II also increase the risk for vulvar carcinoma. • There is a higher incidence in women from lower socioeconomic groups, women with multiple partners and women with a history of infectious vulvitis or a history of vulvar dystrophy (abnormal benign or premalignant skin changes).